The hell of opiate withdrawal

Two years ago I was diagnosed with severe arthritis and debilitating headaches. I was originally placed on Norco 10/325 every 4 hours for pain control. After a few months, my tolerance built up. I becamee very ill due to my headaches which caused extreme nausea and vomiting. I was hopsitalized for almonst a month. I was placed on a Dilaudid (hydromorphone) PCA pump and was sent home on 4 mg 4x daily. Within a month my tolerance was up and I was placed on 8mg Dilaudid 4x daily. Again my tolerance increased and I was placed on Opana ER (oxymorphone extended release) with Norco 10/325 for breakthrough pain. In August 2010 I was sick on being on pain medication as it seemed it was controlling my life and affecting my work. I went to my doctor and told him I was quiting cold turkey. I was given some Ativan for the anxiety which did not help at all. I went through a week of terrible withdrawals and thought I was going to die! I managed to stay off the pills for two months but eventually the pain got the best of me. My physician put me back on Norco which didn't help. I was placed back on dilaudid but began violently vomiting. I was then placed on 15mg oxycodone 6x daily. I too got sick on this. I went back to my doctor who put me on a 25mcg Fentanyl patch. This did absolutely nothing for me but put me in mild withdrawals. Last week I went to my doctor and said enough is enough and I want my life back, pain and all. He refused to take me off the pain medications and would give me nothing for the withdrawals. He instead upped my Fentanyl to 50mcg. I did not fill the prescription. I had been going through mild withdrawals all week and figured I would finish what I started, without my doctors blessing. That was Thursday 2/3/11. Day one was not so bad. However Friday and Saturday I would have given my right arm for pain meds. I was vomiting, had horrible dirrahea, could not sleep, felt like I had the worse flu in the world, was hot one moment and freezing the next. My family has been incredibly supportive. Today, Sunday morning, I woke up feeling relatively human again. I still feel a bit fluish but I can sleep and even took a nap today. The diarrhea is about gone and the fog the pain pills put in my head is gone. I am me again! I will never use opiates again for pain control, instead opting for biofeedback, chiropractic, massage, and acupuncuture. Opiates are truly evil and I despise them. I am seeing my physician this week and signing some sort of contract that he will NEVER prescribe pain medication again. EVER! I feel like me again, like I've got my life back. The withdrawals are sheer hell and I am aware that I will have issues for probably a month or so. I am not psychologically addicted but I am physically addicted. I plan on attending NA meetings just to make sure the temptation stays away. I truly hope that whoever reads this post will realize that yes, withdrawals are hell, but by day 3 or 4 you will begin to function again, reclaiming your life. Please don't take opiates to get high. I understand some of us need them for chronic pain, but there are other modalities out there that can assist and don't take away your life, desires, and motivation. I was living each day until I could get my prescription filled. I lost a job because I couldn't function. Please realize you are strong and can do this. I'm not big on self-control, but I did it and it I can, anybody can! Good luck in getting you life back!

HelloNurse and welcome to Healing Well's chronic pain forum. I do wish you well on your road to to no medication for your pain. But, with you being a nurse I am shocked at your behavior concerning pain medications, you above all should have known the potential dangers of quitting cold turkey. There are safe ways to taper off of pain medications but quitting cold turkey is not one of them. I do hope that anyone reading this understands that quitting cold turkey is not the way to get off of pain medications. As far as I know the members on this forum that are on pain medications it is to help them have a better quality of life, none of them to my knowledge take them to get high, that is what an addict does.

I must say for someone with chronic pain and one who claims to works in the medical profession you are one of the most under educated patients I have ever seen in my life when it comes to chronic pain. Chronic pain is not a one size fits all program. I am afraid massages, chiropractic care and all the other things you mentioned does not work for everyone and why would you even think it would work for everyone is beyond me.

I am very offended by your post to say the least.

First, I will admit pain meds can be a double edge sword, but there are some of us--that would be me--that could not work/function w/o them. I'm a little weary of statements of absolute opinions. As a CP/CI patient of going on 15 yrs now, I had tried everything imaginable holistic, psychological, etc. before my doctors finally agreed pain meds are the way to go for me. It has been my experience once you get a great pain MD they do tend to up dosages if your pain control is not optimal, but this is where I take control and keep my mg to a lower comfortable dosage. Do I still experience break-through pain, yes, but I learn to live with it because I know I will always need more and more if I don't just keep it to a lower manageable level. I was recently hospitalized and discharged on a mind-blowing level of narcotics, but immediately went to my pain MD and discussed a tapering plan b/c I know there's no where to go but up when tolerance hits.
What I'm trying to say is if your quality of life is better on the meds then learn how to manage them effectively.

Straydog, yes, in the beginning I did quit cold turkey. In my clinical experience, abrupt withdrawal from opiates is not life-threatening, just uncomfortable. Going cold turkey from alcohol and benzodiazapines is a different story and should be done under medical supervision. I wasn't on that much pain medication that I was concerned for my well-being. I was more concerned about my ability to function safely as a RN. This time, although my doctor did not want me to quit, I tapered my doses down. This is why my withdrawals have not been too hideous this time around. I will stay off of them. I don't want to be on them ever. I apologize if I offended anyone. I realize we all have different responses to pain medication. While some people function just fine, others such as myself are more sensitive and function in a "fog" of sorts. Pain medication serves a purpose. Perhaps it's purpose is not for me! But perhaps someone else needs it to function and make it through the day. Since opiates are so easily abused, we should always take them according to dr. prescription. I hope this answers some of the questions posted here. Honestly in my original post, I just wanted to yell from the rooftops that I've done it and broken free from these pain medications!

Hi and Welcome to the forum.

Just a couple of words of caution on this subject. Death is unlikely when going 'cold turkey' from opioids but as said above, misery abounds. When a doctor prescribes medication and you choose to take it, I would suggest the best way to stop taking it is with the same doctor's advice. Doctors won't suggest going cold turkey for many reasons and below is a snippet from an article that shows why it can be very harmful.

The abrupt withdrawal of morphine-like analgesics - opioids - can increase sensitivity to pain. Experiments have now shown that this effect is caused by a memory-like process, the long-term potentiation of synaptic strength in the spinal cord. The study, which was supported by the Austrian Science Fund (FWF), also found ways of avoiding this increase in pain sensitivity. These pioneering results have now been published in the prestigious journal Science.

Painful "cold withdrawal"

The abrupt withdrawal ("cold withdrawal") of opioids leads to "long-term potentiation" (LTP) of synaptic strength in the spinal cord's pain pathways. This in turn leads to sustained and increased sensitivity to pain. In the brain, LTP is a physiological mechanism for learning and memory. An activity-dependent increase in synaptic transmission between the nerve cells at their contact points, the synapses, can be very long-lasting. For example in the spinal cord, pain stimuli can trigger LTP and lead to a long-lasting "pain memory". This study proves for the first time that opioids also leave a "memory trace" in the pain system if they are withdrawn abruptly. "We were rather taken aback ourselves by the results," said project manager Professor Jürgen Sandkühler. "Until now, we had assumed that only strong or sustained pain could induce LTP in the pain system." On making this discovery, Prof. Sandkühler and his team set about deciphering the molecular mechanisms of this process.

www.physorg.com/news166449845.html

This is just one article but it serves as a warning to the dangers of taking and/or stopping medications. Whether you or I take or choose not to take any kind of medications is just that...our choice. It's desperately hard to take medications we'd prefer not to take, medications that we are embarrassed to talk about or substances that we never imaged we would need but it's even harder when others look down on our choices. I may disagree with HelloNurse's comments but what I am bothered by is the ending.

Please don't take opiates to get high. I understand some of us need them for chronic pain, but there are other modalities out there that can assist and don't take away your life, desires, and motivation. I was living each day until I could get my prescription filled. I lost a job because I couldn't function. Please realize you are strong and can do this. I'm not big on self-control, but I did it and it I can, anybody can! Good luck in getting you life back!

This is insulting and insinuates I and others here take these medications for fun. I can assure you that less than 1/2 of 1% of chronic pain patients abuse their medications. The statistics prove this out. A quick search will support the facts. I can also assure you than I never feel 'high', I just feel a small lessening of the pain for which I'm grateful. I don't act stoned, drugged, narcotized, hopped-up, fuddled, pixilated, mellow, gamy or juiced. More often I am sleepy from the meds and the consistent pain. If you were "living each day until I could get my prescription filled" and you "lost a job" then my suggestion would be you were the small percentage whose body chemistry doesn't tolerate these medications without becoming not only dependent but addicted. It's most often not a choice any of us make, it's part of our make-up.

The people you will meet here are almost always in control of their medications. Those who aren't are either open and asking for help or are in denial and we offer our support for them too. That's what this forum is all about...support. I've listed one of the forum rules below as a reminder. Support is not hurtful but kindness and experiences shared in a helpful way is.

I wish you well, Nurse.
Chutz


4. No posts that attack, insult, "flame", defame, or abuse members or non-members. Respect other members of the community and don’t belittle, make fun off, or insult another member or non-member. Decisions about health and well-being are highly personal, individual choices. "Flaming" and insults, however, will not be tolerated. Agree to disagree. This applies to both the forums and chat.

Just a quick chime in here since I've had the experience of a nurse making my PM decisions for me over the last two days. (I say nurse because she didn't follow the dosing approved by the dr, but rather what she thought I should be taking) while she was on the floor.

Anyway, this nurse was so uninformed about meds that she withheld my controlled release xanax cr 3 mg that I have been taking for years for over 7 hours and then tried to give it to me several times a day. She decided for herself which of my meds I should take together, althogh all of my pain meds (3) are written at 120 a month (4 a day, as needed). This meant to her that I needed them every 6 hours or not at all. I tried and tried to explain that I can't take oxy and dilaudid together, but I can take oxy and Ultracet or dilaudid and Ultracet, but this continued for the whole time I was there. Then she would write on this huge board what meds I was taking and what time to give them to me (can you say not what I want everyone in the family to know????) Then I would be waken up from a dead sleep to take a med that she thought I needed during the middle of the night. And last, she would keep telling me she was going to give me my shot of morphin now and I'd have to tell her I can't take morphine....I'm alleric over and over and over. She said it was a standing order for all cardiac patients and they just brought that one. But, enough of my story and on to my point.

Nurses are wonderful people to take care of us in our times of need. Some understand medicine and the effectes of meds extrememly well, but I have found many nurses to know just enough to be dangerous when it comes to medical opinions and prescriptions.

I appreciate what our new member is saying about her situation, but most of the people who come here have tried everything possible to reduce pain to a managable level. Most take combinations of meds to improve pain control rather than continue to increase meds that are not working well. Almost all (including myself) are under pain contract with a reputable pain management clinic and are given UA's all the time. It's part of life for us. I've been doing UA's so long (for 20 years with work) and now with PM, that it's just an old hat now. If you're not abusing or using meds not prescribed for you, then taking a UA should be no problem at all.

 

  

      Nurse,

 

      When you do get to the point that you do have disabling chronic pain (and you will one day) there are many medications that are recommended for those that need pain control long term. Also, you have now placed yourself in a very difficult position. You views on chronic pain and pain relief methods are negatively impacting your life. It will negatively impact you ability to perform in your chosen profession as well. It would be good to speak with your doctor about the feelings you are experiencing so he/she can refer you to someone who will help you process your feelings and process what you have done to your body. I hope you are able to find some sort of balance.

 

    It was very nice to meet you.

 

  

Dani

i did not even finish reading your whole story. the "cure" is not the cause. i think when you made the change from 8mg dilaudid 4 per day to opana ER mg ? with norco 10/325 was a huge step down and screwed up your nervous system. and withdrawals with just ativan is torture. what kind of doctor is treating your pain?

I agree with all who have posted here regarding Nurse's post. Chronic Pain by itself is very personal. Even though I hate my meds...taking at least one every 6 hours, 1 every eight hours, one I take two twice a day and the rest are randomly placed in both morning pill box and evening pill box, isn't exactly my best laid plan. However, like everyone who takes pain medications, I take them so that I can function. So that I can do the dishes once in a while, vaccum the floors once in a blue moon and be able to go do things with my husband twice a month.

I have had so many problems with my meds, but I know that without them I would be in bed 24/7 and not be able to do anything but cry because of the pain. I have recently learned that my disc at L2-L3 is herniated. Although it is only slightly herniated, if it should ever become to the point where it was causing my back to hurt in other places, I could never go through surgery to fix it.

No ortho or neurosurgeon will touch my back ever again and that alone makes me realize that the medications are all that I have. I've tried biofeedback, chiropractic, acupuncture, massage therapy and thousands of other thing to try and control my pain before I opted for any medications. I know that there is no way I will ever be the same again and that without my long acting pain med and my IR oxy and my muscle relaxer, that this is my life.

My husband says that I was given a horrible hand, but that hasn't stopped me in everything I want to do. I can't walk for any longer then a block and a half without being in excruciating pain. I cannot sit in a chair for longer then 5 minutes without my legs screaming at me or having muscle spasms that make me cry. I am stuck with my CP and there is no way out.

I am a CP Patient, not a addict....nor a druggy. I don't get high, looped, drugged nor do I go looking for a "Fix". I am appauled by your statements that we all here are addicted to our meds. We here are dependent for a decent life on our meds and that doesn't make us bad people.

Scarred

Retiredmom, I had a friend in a similar situation, the surgeon, also managed her chronic pain prior to the surgery, and he did write for her to continue home meds. What he did not do was write out these meds which included her MS Contin, MSIR, and flexeril, baclofen, etc. The anesthios. and surgeon one wrote her post op pain meds, and did not write in addion to the regular meds she took for chronic pain. Many nurses donot clarify orders and think that the post op meds take the place of the meds they take daily, as most patients do not have orders for pain meds at home, that they take on a daily basis. It also needs to be writeen out that (forexample) MS CONTIN 50 mg po BID(q12hours at 7am and 7Pm,MSIR every 4-6 hours po as needed for breakthrough or uncontrolled pain, Flexeril 10 mgpo every 6 hours as needed for spasms) The post op would proably be a pump. Anyway, make sure that the doctor makes sure to write that your regular home meds are in addition to your post op meds, and that they are writeen exactly as you take them at home.. That is my best answer as a longtime nurse.

Just joined to reply to Nurse. Good for you, we each must face this based on our unique personality. What started for me as a supraorbital neuralgia and small arnold chiari malformation has led to my having a body with many different pains said to be from 3 pinched nerves , peripheral neuropathy, fibromyalgia and a couple of others I can't spell. I have been on every anti convulsant used for pain with no effect so for over 13 years oxycontin allowed me to function and succeed in my career, then 2 years ago I started developing extreme body pains diagnosed as fibromyalgia. Oxycontin was increased till I was taking 320 mg or more a day, usually more which left me low on meds at the end of the month, which left me in a bad way for two or three days. Guess what, my newer pain symptoms are very similiar during the middle of the month as the symptoms of running out of the oxycontin. I assume, and the Doctor agrees I may be suffering from an opiate intolerance. These last 2 years have been hell, as to my quality of life; but these last 6 days of cold turkey have been a whole new level of hell. I don't know if I could taper off, so I chose cold turkey. I know cold turkey posts seem to upset some members who utilize tapering or low dose pain management. You can feel the anger and emotion in their posts. Medical papers and studies are cited, and statements like "Doctors won't allow it" are made. Doctors do allow it, and it is the method used by state & state supported agencies for detox in Florida.
I am not writing to antagonize, only to let nurse know she has support from me, a 57 year old man whose brain has been rewired by his medicine and who hopes his quality of life will increase after a few months of no opiates, synthetic or otherwise.

Hellonurse,
I am glad for you...but to say that all pain meds are Evil is generalizing all of us that take them... I hope you aren't trying to say that all of us need to get off of the pills in order to be Human... I have been taking pain meds for severe pain for over 10 years...120 mg. Methadone and 30 mg. Oxycodone 5 times a day... I wish like hell that I didn't NEED to take them, but I do, and I will.

And as for the NA meetings...Be Ware!! The meetings that I went to were more like a junkie meeting where everyone talks about "the good old days".

Going through withdrawals is the worst...and anyone that can go through it and get to the other side is a Miracle...But before you sign that New Contract stating that you will Never allow the Dr. to give you pain meds...I'd think about it... You might need them one day for an emergency and your Dr. will say "NO".... That would Suck!!

Hello Nurse, I'm sure by now you've realized how your wording could have been a little better. When my grandmother (the most important person in my life) was in the hospital dying, she had the worst nurse in the world. This woman was rude, loud, and obnoxious. Our family was literally saying our "last goodbyes" and this nurse still had no compassion. Does that mean that every nurse is like that except you? I'm sorry you had a bad reaction to medication, my aunt can't take medication either, she goes to a church about 10 minutes from my house. Good luck with your contract.